Abstract
BackgroundLittle is known about whether and how medical knowledge relates to interest in subspecialty fellowship training. The purpose of this study was to examine the relationships between residents' interest in subspecialty fellowship training and their knowledge of internal medicine (IM).MethodsA questionnaire was emailed to 48 categorical postgraduate-year (PGY) two and three residents at a New York university-affiliated IM residency program in 2007 using the Survey Monkey online survey instrument. Overall and content area-specific percentile scores from the IM in-training examination (IM-ITE) for the same year was used to determine objective knowledge.ResultsForty-five of 48 residents (response rate was 93.8%) completed the survey. Twenty-two (49%) were PG2 residents and 23(51%) were PGY3 residents. Sixty percent of respondents were male. Six (13%) residents were graduates of U.S. medical schools. Eight (18%) reported formal clinical training prior to starting internal medicine residency in the U.S. Of this latter group, 6 (75%) had training in IM and 6 (75) % reported a training length of 3 years or less. Thirty-seven of 45 (82%) residents had a subspecialty fellowship interest. Residents with a fellowship interest had a greater mean overall objective knowledge percentile score (56.44 vs. 31.67; p = 0.04) as well as greater mean percentile scores in all content areas of IM. The adjusted mean difference was statistically significant (p < 0.02) across three content areas.ConclusionsMore than half of surveyed residents indicated interest in pursuing a subspecialty fellowship. Fellowship interest appears positively associated with general medical knowledge in this study population. Further work is needed to explore motivation and study patterns among internal medicine residents.
Highlights
Little is known about whether and how medical knowledge relates to interest in subspecialty fellowship training
Authorities like the SGIM have advocated that the current 3-year internal medicine training format be lengthened to 4 years [5], while subspecialists and subspecialty groups like the Cardiology Working Group 8 have proposed shortening the length of residency so that residents can quickly advance to subspecialty training [13,14,15]
The American College of Physicians, which is closely aligned with accreditation bodies for internal medicine residency and fellowship programs in the United States is in favour of maintaining the status quo 3-year model, with a proviso to provide “core” training focused on general internal medicine in the first 2 years and customized training tailored to ultimate career goals in the last year [9]
Summary
Little is known about whether and how medical knowledge relates to interest in subspecialty fellowship training. Authorities like the SGIM have advocated that the current 3-year internal medicine training format be lengthened to 4 years [5], while subspecialists and subspecialty groups like the Cardiology Working Group 8 have proposed shortening the length of residency so that residents can quickly advance to subspecialty training [13,14,15] Amid such debate, the American College of Physicians, which is closely aligned with accreditation bodies for internal medicine residency and fellowship programs in the United States is in favour of maintaining the status quo 3-year model, with a proviso to provide “core” training focused on general internal medicine in the first 2 years and customized training tailored to ultimate career goals in the last year [9]
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